Demographic and environmental risk factors for exposure to Lawsonia intracellularis in horses in Israel

Equine proliferative enteropathy (EPE) is an enteric disease of foals that is caused by Lawsonia intracellularis. Clinical cases have been reported worldwide; however, data regarding the epidemiology of L. intracellularis in horses are scarce. Thus far, L. intracellularis has not been reported in the Middle East. The objectives of this study were to determine whether the causative agent of EPE exists in horses in Israel and in the Palestinian Authority and to define environmental and demographic risk factors for exposure. Fecal and serum samples were collected from horses from various regions of the country. The presence of L. intracellularis in horses in Israel was determined by real-time polymerase chain reaction (PCR), and seroprevalence was determined by enzyme-linked immunosorbent assay. One fecal sample of 136 tested (0.7%), was PCR positive. Sixty-seven sera samples (30.5%) of 220 horses in sentinel farms had anti- L. intracellularis antibodies. Low seroprevalence was found in foals both from Israel and from the Palestinian Authority (4.2% and 13.3%, respectively). In logistic regression models, geographical locations, management type, and age were found to be significant risk factors associated with seroprevlaence to L. intracellularis. No significant correlation was found between environmental variables and L. intracellularis seroprevalence after controlling for management type. These results support the existence of L. intracellularis in horses in both Israel and the Palestinian Authority. The reasons for the relatively low prevalence are currently not known and may be the result of different management, low exposure to free-living animals, and differences in environmental variables affecting the bacterial burden.